诱导剂修改对于老年移植接受者的必要性
Kyeong Deok Kim1,2, Kyo Won Lee2, Jae Berm Park2
1Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
Kidney research and clinical practice
|November 3, 2023
概括
老年器官移植接受者在接受子抗胆小细胞球蛋白 (r-ATG) 治疗时经历的排斥较少,但感染和死亡较多. 调整免疫抑制,如减少r-ATG剂量,可能对老年患者有益.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 老年病的医生 老年病的医生
背景情况:
- 免疫衰变会损害老年人的免疫功能,增加感染易感性和移植排斥.
- 适应年龄的免疫抑制对老年器官移植接受者至关重要.
- 这项研究检查了诱导剂巴西利克西马布和子抗胆小细胞球蛋白 (r-ATG) 在老年人与年轻人移植患者.
研究的目的:
- 评估老年和年轻器官移植受体的临床结果,特别是排斥和感染率.
- 根据患者年龄,比较巴西力西马布和r-ATG作为诱导剂的疗效和安全性.
主要方法:
- 从2011年6月到2019年4月,对704名移植 (KT) 患者进行了回顾性评估.
- 患者被分为年轻和年长的接受者群体.
- 感染和活检证明的急性排斥 (BPAR) 的结果基于诱导剂 (basiliximab vs. r-ATG 4.5 mg/kg) 进行了比较.
主要成果:
- 这项研究包括520名年轻 (74.6%) 和179名年长 (25.4%) 的受试者.
- r-ATG使用与6个月内的BPAR较少相关 (p=0.03).
- 接受r-ATG的老年患者在6个月内感染率更高,感染相关死亡率增加 (p=0.003).
结论:
- 对于年长的器官移植接受者来说,可能需要更少的强化诱导疗法.
- 减少r-ATG的剂量是优化老年人免疫抑制的潜在策略.
- 根据年龄量身定制诱导疗法可以改善移植患者的治疗结果并降低移植患者的死亡率.
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